Dental Tribune Middle East & Africa Edition No.2, 2016

Dental Tribune Middle East & Africa Edition | 2/2016 36 ortho tribune tient? In his Master’s Thesis in Ortho- dontics at the University of Insubria, which is expected to be published in some time, Dr. Piero Antonio Zecca, demonstrates the superimpossibil- ityofdataobtainedfromatradition- al cephalometry and a cutaneous cephalometry from a 3D scanning ofthepatient’sface,withoutanyfur- therradiation. What doesit mean? The Digital Disruption is deeply changing our way to work as ortho- dontists. It is the moment when new technologies generate a major changeinanestablishedactivityand totallymodifythepreviousmodel. Professor Clayton Christensen at Harvard University, who has invent- ed the Digital Disruption tool, has demonstrated how such a change took place many times in the past but, while once it was a high cost deal with a very long period of im- plementation, today - with digital technologies coming into play - the processhassteppedupconsiderably. Disruption and innovation are inter- related! Is disruption the only way to innovate? According to Professor Christensen, it is the best way to do sobecausewhendigitalinstruments dotheinnovation,theresultismuch better. From3Dto4D Starting by the intraoral digital scanningofthedentalarches,wecan obtain virtual models and the oc- clusal details of a patient can be ana- lysed and measured, without resort- ingtostonemodels.Thistechnology wasnotconceivableatallsomeyears ago. A digital set up of orthodontic movements can be performed on such virtual models to simulate and define treatment objectives, to pro- ject appliances and to develop skills howtoapplyit. Duringthetreatment,newvirtu- almodelscanbeobtainedbyfurther digital scans of the dental arches, which may be superimposed on the initial ones, if desirable. In this way, it is possible also to monitor the pro- gressionofthetherapy. In more complex cases requir- ing morphologic diagnosis, it is possible to superimpose the digital models and the 3D reconstruction of the maxillary bones and the roots obtained from the CBCT. By specific software, one can do a set up that considers the real anatomical limits of the radicular movement, which is named “set up bone safe”. (Figures 9-10). In this case, the virtual tooth of the patient is obtained by mixing the crown derivated from the intra- oralscanandtherootfromtheCBCT. In this way, the radicular position in the maxillary bones could also be defined during and at the end of the treatment by repeating the intraoral scan, without further exposure to X- rays. It is thus possible to monitor the real progression of the orthodontic treatment, respecting the anatomi- cal limits of the patient, evaluating systematically the match to the set upand,ifnecessary,restructuringit. The follow up to our cases is not any longer confined to controls administered after the treatment. It becomes a dynamic concept, where time does not tell us what we have to do with the orthodontic therapy, if we identify the right moment of treatment. The virtual follow up tells us what is happening today, now, be- yond what our eyes see and with maximumcareforthepatient. 4D Orthodontics introduces a diagnostic fourth dimension, which relates to the time that flows and communicateswithus. References 1. Ortognatodonzia Italiana vol. 14, 1-2007:13-20 2. Am. J. Orthodontics October 1956, vol.42N°10;Pag740-748 3.AngleOrthod1979Jan;49(1):47-55. 4. Am J Orthod Dentofacial Orthop 2008;134:597-8 5. Ana R Durão1, Pisha Pittayapat, Maria Ivete B Rockenbach, Raphael Olszewski, Suk Ng, Afonso P Ferreira and Reinhilde Jacobs. Progress in Or- thodontics201314:31;3-11 ◊Page34 Fig.7.Followupafter twoyears Fig. 9. In red the ideal set up of 3.3 without considering the real anatomical limits:theroot isoutside thebone Fig.8.Followupafter twoyears:note thepreseceofhealtygingiva Fig.10.Inblu thelowerarchset upconsidering thebonelimitsof thepatient CEREC Zirconia: Valued material can now be used chairside ByDentsplySirona Full contour zirconia has become a very popular material in dental of- ficesduetoitshighflexuralstrength, biocompatibility and tissue-con- serving preparation. Dentsply Si- rona CAD/CAM has introduced a world class technology to make the impossible possible: Thanks to an outstanding innovative workflow CEREC allows dentists to process and place full contour zirconia in a sin- glesession. CERECnowprovidesacomplete- lynewprocesstodentalpractices:by combiningthenewCERECSpeedFire furnaceandCERECZirconiamaterial, dentists can now deliver full contour crowns and small bridges made of the full-strength high-quality zir- conium oxide in their own practice whilethepatientwaits. High strength, short manu- facturingprocess The greatest benefit of CEREC Zirco- nia is the high flexural strength of the material.1 It is suitable for indi- vidual crowns as well as small bridg- es and can be processed in thin wall thicknesses. Since these restorations are manufactured in monolithic form, there is no risk of chipping. Another benefit for dentists is that zirconium oxide can be cemented conventionally. CEREC Zirconia is a pre-shaded translucent zirconium oxide avail- able in 10 shades on the basis of the VITAClassicShadeGuide®. The material is milled in an en- larged form and then densely sin- teredtoitsfinalsizeinthenewsinter- Fig. 1: CEREC Zirconia can be dry milled with the CEREC mill- ingandgrindingunit. Fig.4:CrownmadefromCERECZirconiaaftersintering. Fig. 5: The CEREC SpeedFire sintering furnace is the small- est of its kind on the market and really saves time with a sinteringprocessthat takes10-15minutesforeachcrown. Fig. 3: The product family for the chairside production of CEREC Zirconia inthe practice (from right): CEREC AC with Omnicam,thenewCERECSpeedFiresinteringfurnaceaswell as theCERECmillingandgrindingunit Fig. 2: The new sintering fur- nace CEREC SpeedFire needs 10-15minutesforcrowns ÿPage38 Dental Tribune Middle East & Africa Edition | 2/201636